International Student Alumni: Clarisza Runtung
In Their Own Words
Clarisza Runtung, Nursing Student, Washington, D.C.
When I began my conversation with Clarisza Runtung, we were both quick to make half-joking, half-serious quips about our upcoming exams. Mine was the LSAT, and hers was the NCLEX, the licensing exam nurses must take in order to embark upon their careers. The circumstances surrounding her exam transcended the average test anxiety: “I have no idea where my life will take me in the next couple of weeks even.”
The uncertainty that the NCLEX posed for Clarisza was not an unfamiliar feeling. Ten years ago, Clarisza moved to the United States to pursue her education at the University of Michigan, where she began as a film student and later transitioned to theater. After she had graduated, she became thrust into the world of visas and immigration, applying for Optional Practical Training (OPT) and delving into a period of constant paperwork filings and awaiting updates. OPT is the extension of a student’s F-1 visa status, which temporarily enables them for a 12-month employment authorization in a field directly related to their studies. Although a job offer is not required to apply for OPT, upon completion and acceptance, the countdown to secure a position begins, with only 90 days allowed for unemployment.
Clarissa was granted OPT after her B.A. degree and would only be permitted to apply again after completing another degree. She expressed to me that, although it was unfortunate, she could recognize and grapple with the difficulty of securing sponsorship with a theater degree. Consequently, when she decided to pursue her Masters of Science in Nursing at Georgetown University, she felt far more optimistic about both her job prospects and the likelihood of securing sponsorship.
Her optimism was anchored to STEM OPT—an additional 24-month extension of the standard 12-month OPT offered to those F-1 students who earn their degrees in science, technology, engineering, or mathematics (STEM). “Coming into nursing school, I thought, ‘I have OPT STEM. I get the extra time, I can work for the three years, and after that, I can apply for a green card.’” She paused before asking me. “You know what the first news I heard was when I started nursing school?”
“Nursing is not considered STEM.”
I furrowed my brow, utterly flummoxed by this revelation. If nursing is not considered STEM, then what is it? A quick search into the prerequisites and core classes of a nursing degree revealed how deeply entrenched the field was in hard sciences. From chemistry to mathematics and physics, nursing was by no means a soft science. The Biden administration announced on January 21, 2022 that 22 new fields of study have been added to the STEM OPT program, but nursing was not among those professions.
“And some hospitals say ‘We will sponsor [you] after you work for us for two years, and I’m thinking well I only have one year to work with OPT, but then the hospital will only sponsor me after two years of experience in their hospitals, so it feels like a catch 22. It almost feels like I am set to fail!”
These anxieties and frustrations followed Clarisza throughout her time at Georgetown. Without the security of STEM OPT to fall back on, she began her hunt, not for a job but merely for a hospital that would sponsor non-citizens. “When I got accepted into nursing school, in a Master’s program, in a pretty well-known university, I thought, ‘My god! I am set for life!’ I thought my job security is well in place, and my visa situation would be resolved. We always need more nurses. But anytime I would mention immigration, they would say ‘No.’ or ‘We don’t know anything about it.’”
Beginning her first year in her program, she started calling hundreds of hospitals and recruits, asking if they would sponsor. All of them informed her that they would not. She told me a story of a job panel that she had attended. With five recruiters and nearly all of the hospitals in Washington D.C. on the Zoom call, Clarissa asked, “Do you sponsor non-citizen nursing students to work?” She recalled the awkward silence before hearing a cascade of no’s that reached the final recruiter. “I remember her to this day. She said, ‘No, it’s too much paperwork.”
“It was really depressing, and it’s not just me. We pay twice the amount of those who are citizens, and we’re not even given a chance to get a job. Professors would tell us, ‘You guys are Georgetown students, you will definitely get a job,’ and I’m thinking, ‘No, not me,’ just because of my immigration status.”
“They see us foreign nursing students as immigration liability,” she continued, “instead of an asset they could use – I think that’s unfair. We all pass the same licensing exam and all take the same classes, so why is this immigration status such a barrier for us getting a job?”
“You’re trying to go through nursing school, and yet you know at the end of the line a lot of doors are already closed to you, without even looking at what you have accomplished throughout nursing school, and then you ask yourself ‘What am I doing? Was it all worth it? Why am I even going to nursing school?’”
Importance of School Support
I wondered if anything at the institutional level at Georgetown could have been done to support Clarisza. She revealed to me that there was an gap of knowledge between the Nursing Department and the International Student Office. Although the International Student Office harbored all of the information pertaining to visas and the various timelines associated with applying and gaining approval, “they knew nothing about the nursing license and the timeline for that.” Meanwhile, the Nursing Department had all of the necessary information regarding the licensing exam and the associated deadlines but had no knowledge of the timeline for her visa.
“Honestly, at the end of the day, I’m playing everything by ear and synthesizing all of this information by myself because there is no one else to help.” Bridging this knowledge gap for her nursing department was something Clarisza swore she would do, “As soon as I get a job and get things figured out, that’s something I promised them I would do.”
And now, after completing her degree, Clarisza was in the eye of the hurricane. Our conversation took place during the intersection of her licensing exam, her job interviews, and her visa. Yet, within the span of 90 days, she was to pass her exam, apply for OPT, and secure a position. And as her journey had already proven to her, finding a hospital to not discriminate against her based on her status as an immigrant was no easy feat.
Joining the Workforce
Clarisza shared that while there are hospitals that are willing to sponsor, they tend to be those that are in less favorable locations and where a majority of people do not wish to apply. As she listed them to me, her options were the following: F-Grade hospitals, long-term care facilities, or working with an agency.
“We immigrants always have to sacrifice and engage in the work that no one else wants to do. We’re not given equal and fair opportunity to get the jobs that we want, and instead we are pushed to do the jobs that no one else wants. We’re being forced instead of making a choice–it takes a lot of psychological readiness to think I’m going to go in the middle of nowhere because it is my calling.”
Despite her extensive training and passion for her work, Clarisza acknowledged that the barriers to entry were prohibiting her from filling the positions she truly aspired to pursue. In speaking with an immigration lawyer, an additional facet of discrimination presented itself to her; she told me, “the academic hospitals and the big hospitals don’t want to sponsor because they want the best of the best.” There is a deeply embedded misconception that non-citizen or immigrant workers lacked the certain superlative quality of their citizen counterparts. “Foreign-born nurses are seen to be less than,” she noted, “Hospitals don’t even look at my resume because I asked for sponsorship, and it’s really heartbreaking to be in that position, and something needs to be changed.”
The agencies she had mentioned are one way that many F-1 nursing students secure positions with hospitals. Clarisza had become cognizant of the contingencies of such an option. “[The F-1 nursing students] are liable to a three-year contract; they don’t know where they’ll be placed, and because they are contracted through the agency and not the hospital, they forgo any of the benefits that the hospital would have,” including the pay.
“I want to do so much more, and I don’t want to be limited because of my immigration status. I feel like no one should be put in that position.” Unfortunately, their constricted options have put many non-citizen nurses in a bind that ultimately hinders them from achieving their fullest potential as clinicians. Many of them have even begun to move to Canada, a country Clarisza mentioned that “doesn’t shy away from immigrants, and they grant visas there more easily.”
She fervently expressed her readiness and eagerness to join the nursing workforce, but the obstacles posed a hindrance not only for Clarisza, but also for the economy. “We aren’t able to contribute to the nursing shortage, which is a huge loss for the country.” Countless articles and studies have echoed her sentiments into the Brain Waste phenomena of immigrant and refugee students, especially those with health-related degrees.
America Needs Nurses
As the Migration Policy Institute had documented, nursing is the most common degree held by underutilized immigrants nationwide and in most states. Forty-six percent of U.S. immigrants with health-related undergraduate degrees who experience brain waste had formal training as nurses. This was also true of roughly half of sidelined immigrants with health-related degrees in California, Florida, and Texas. The predominance of immigrants with nursing degrees among the underutilized was even higher in Hawaii (77 percent) and Nevada (67 percent).
This untapped source of educated and diverse clinicians demonstrates an enormous space in the country and the economy that could be quickly filled with highly-qualified and US-trained professionals.
Although buzzwords such as “diversity,” “equity,” and “inclusion,” have been swirling around companies’ rhetorical arsenals, and have even been adopted by hospitals in their job postings, their efforts in ensuring those like Clarisza have even a chance at joining their team are lukewarm at best.
“The applicant pool will be so much better. A lot of us speak more than one language! We could bring so much to the hospitals and the healthcare system.” And with an ever-diversifying population, patients in the United States have a right to feel represented by their nurses and doctors, culturally, linguistically, ethnically, or religiously.
Ultimately, the pipeline from education to employment is broken. The failures on the part of the government, for not considering nursing to be a STEM field; to the institutional-level, where Georgetown lacked the structure to aptly guide their international nursing students; and finally, to the hospitals, where there is a refusal or resistance to doing more to get students like Clarisza sponsored and integrated, all expose a cracked and fragile infrastructure.
“It’s really dark,” she laughed, “I wish there was a bright side, but it all feels so helpless.”
Despite the overwhelming sense of futility, Clarisza was resolute and undaunted by the work needed, not only to bring change and reform but to ensure harmony exists between the many institutions that immigrant students rely on.
“While the situation is grim and can make people feel hopeless, I know I was, it is still important to remain hopeful. Yes, I was sad and angry, but I know that this can be worked out.”
As the pandemic tumbles into its second year, students and workers like Clarisza are essential to more than just our workforce. Immigrant students are integral members of our communities and invaluable forces in our efforts to become more. Clarisza’s story—from her grit, humor, and patience–gives us reason to stand in solidarity with the immigrant and international students of our country, to demand more than hope, and to expect change.